Organization
ONE SOURCE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM KEITH WADE (VICE PRESIDENT)
(228) 875-3828
Entity
Organization
Contact information
Practice address
3004 BIENVILLE BLVD, SUITE 1, OCEAN SPRINGS, MS 39564-4370
(228) 875-3828
Mailing address
3004 BIENVILLE BLVD, SUITE 1, OCEAN SPRINGS, MS 39564-4370
(228) 875-3828
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
MS
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0440404
—
MS
Enumeration date
07/13/2005
Last updated
08/17/2020
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